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Nerve-sparing laparoscopy
can become a treatment of choice as it demonstrated significant improvement in
pain and functional outcomes in patients with deep infiltrating endometriosis.
According to a
recent study published in the “Archives of Gynecology and Obstetrics” journal,
nerve-sparing surgery is a practical approach to manage deep infiltrating
endometriosis (DIE) of the posterior compartment. The strategy also improved
sexual, rectal and bladder functions significantly along with satisfactory pain
reduction.
A recent assessed
study by Stefano Uccella and colleagues determine a significant role of
nerve-sparing intervention in managing deep infiltrating endometriosis (DIE)
and related pain and other complications. Other approaches like radical
eradication are related to the elevated risk of pelvic dysfunction and
iatrogenic autonomic denervation. Nerve-sparing is another surgical approach.
This study was conducted to determine nerve-sparing peri-operative features and
postoperative functional results related to rectal, sexual, bladder functioning
and pain reduction in patients with DIE.
The females with DIE
nodules of the posterior compartment ≥ 4 cm ± bowel resection who were going through laparoscopic nerve-sparing
eradication surgery were selected for the analysis. Visual Analogue Scale (VAS)
is used to noticed pain scores before and 6 & 1 year after the surgery. The
NBD, ICIQ-UISF and FSFI questionnaires were used to determine rectal, bladder
and sexual functions before and six months after the treatment.
The analysis
involved 34 patients; out of which 28 patients already went through a previous
abdominal surgery and left 16 patients subjected to bowel resection. The pelvic
pain scores six months and one year after surgery were considerably reduced to
median 3, range 0–7 and 2, 0–7 and 3, 0–8 and 2, 0–7 respectively as compared
to pre-operative scores ( 9, 1–10 and 3, 0–7). ICIQ-SF questionnaires showed no
difference between pre- and postoperative urinary functioning. NBD scores
reduced from 3.5 to 2 at six months after the treatment (p = 0.72). No
self-catheterisation of the bladder was required at six month and one-year
follow-up. The total FSFI scores shifted to 22.7 from 19.1 after the treatment.
Archives of Gynecology and Obstetrics
Functional outcomes of nerve-sparing laparoscopic eradication of deep infiltrating endometriosis: a prospective analysis using validated questionnaires
Stefano Uccella et al.
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